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Week 1 Which of the following statements about pharmacodynamic phase is correct? Pharmacodynamic phase is related to the drug-receptor interaction and its biological effect. Which phase is most concerned with drug absorption and metabolism
Pharmacokinetic phase
Bioavailability is affected by which of the following factors?
Drug's solubility
What is true about competitive inhibitors? They act at the same site as the drug. What is most likely to increase an activator's (i.e. an agonist's ) efficacy? Allosteric agonist Which of the following drug characteristics makes a drug more likely to enter a cell through a protein channel? Water solubility What type of substances can act as agonists or antagonists? Select all that apply. Neurotransmitters Drugs Hormones What is the antagonist of choice to counteract the action of opioid receptor agonists? Naloxone Which natural agonists have similar effects to morphine by activating the opioid receptors? Endorphins What name is given to the proteins that, when receiving specific chemical signals, activate or inactivate cellular processes Receptors Which term describes the ability of a drug to activate a biological effect? Agonism
What best describes the selectivity of a drug? What effect does an antagonist drug have over the receptors? Causes the associated cellular process to be blocked What best describes the selectivity of a drug? The proportion of preference a receptor has for a drug Which statement most accurately describes a drug with high efficacy and high potency? It requires only a small dose to exert a significant effect. Which receptor type typically functions using cAMP as a mediator? G-protein coupled receptor What is the main reason behind limited bioavailability of benzylpenicillin? The beta-lactam ring of benzylpenicillin is highly prone to acid catalyzed intramolecular hydrolysis. Which of the following statements is NOT true? If given in its unaltered form as an oral medication, tetracycline will effectively interfere with the protein biosynthesis process in eukaryotic cells. To cross the blood-brain barrier, a drug molecule should possess which of the following characteristics? Highly lipophilic with small molecular mass What best describes EC50? The effective concentration of a drug produces 50% of the maximal effect. A patient is being treated for depression with a specific medication. The pharmacokinetic profile of this medication reveals a dissociation constant (Kd) of 344 pg/mL and an effective dose for 50% of the population (ED50) of 200 pg/mL. What can be inferred from these pharmacokinetic parameters? The presence of spare receptors can be inferred from these values. What is the definition of pharmacodynamics? The effect of drugs on the body In pharmacodynamics, what term is defined as the biggest effect that a medication can have in the body?
Neurons The expression used to point out the fact that laboratory findings from testing an organism in vitro are not always reflected when applied to an organism in vivo is In vivo veritas Which of the following is a common feature of the physiologic process in the body Redundancy The plasma membrane is responsible for. regulating the movement of molecules and ions into the cells Which of the following statements is true The cell is dynamic and constantly in motion Which of the following decreases the oxygen-carrying capacity of the blood Carbon Monoxide poisoning Which of the following are part of the basic cell-housekeeping functions? Generation of energy Which of the cellular functions is the first to be affected by hypoxia? ATP generation Which of the following is one of the mechanisms by which infections cause cell injury Activating the host's immune system Which of the following cell types is most susceptible to ischemic injury Neurons Pyroptosis is suicide by inflammation Which of the following is utilized by the cells as a mechanism of self-preservation Autophagy The changes made by a cell in response to injury or adverse changes in their environment are referred to a Adaptation
Which of the following is a common symptom in an infant with milk protein allergy Blood in the stool Which of the following is not typically seen in anaphylaxis Bradycardia Which of the following was theorized by T.A. Knight in his work with pea plants? Alternate forms of traits Which of the following tests helps identify an allergen that causes an allergic reaction? Radioallergosorbent test (RAST) Which of the following foods accounts for 2 to 3% of food allergies in children under 1 year of age? Cow's milk Which of the following diseases requires endoscopy and biopsy for confirmation of diagnosis? Eosinophilic esophagitis Which of the following causes cell damage by inhibiting the electron transport chain Cyanide How does acetaminophen cause cell injury Formation of toxic metabolites Which of the following will result from reduced activity of Na⁺/K⁺-ATPase? Increased intracellular Na⁺ concentration Which of the following will result from the deactivation of oxidative phosphorylation? Accumulation of lactic acid Which of the following is responsible for activating the apoptosis pathway in a mitochondrial injury? Cytochrome C All of the following are known to cause angioedema EXCEPT ... ondansetron. Which of the following types of hypersensitivity reactions is IgE mediated
A slowdown in the speed of electrical conduction through the AV node Which statement best describes esmolol? A beta-1 receptor blocker with rapid onset and short duration of action Which of the following can cause a heart attack (myocardial infarction)? A clot obstructing a coronary artery Which of the following statements concerning angiotensin-converting enzyme inhibitors (ACEI) is TRUE? ACEI are an effective therapy for hypertension and heart failure.
Which of the following drugs is used in the management of hyperlipidemia?
Simvastatin
What is a common side effect of phosphodiesterase type 5 inhibitors, such as
sildenafil (trade name, Revatio, when used for the treatment of pulmonary arterial
hypertension, and Viagra, when used for erectile dysfunction)?
Headache
What category of drugs used to treat pulmonary hypertension acts by increasing the
amounts of cyclic GMP in the smooth muscle cell which causes decreased
intracellular calcium, less actin-myosin interaction, and vasodilation?
The guanylate cyclase activators
Which two drugs are dihydropyridine calcium channel blockers? Nifedipine and amlodipine Which of the following medications typically causes reflex tachycardia? Nifedipine What is the mechanism of action of minoxidil? Dilates arteries Which of the following medications is LEAST likely to cause reflex tachycardia? Diltiazem For patients receiving pharmacologic treatment for hypertension, what is the target blood pressure (according to the Journal of the American Heart Association, the International Society of Hypertension, and the World Health Organization)? Less than 140/90 mm Hg Which statement is TRUE about blood pressure reduction in hypertension?
Treatment below the standard target to <135/85 mmHg provides a slight additional benefit in myocardial infarction risk reduction. Which medication should be included in the treatment of hypertensive patients of African descent? Calcium channel blockers In a patient with hypertension, which comorbidity should prompt consideration for addition of a beta-blocker? Ischemic heart disease What best describes the difference in mechanisms between sildenafil and nitrates? Sildenafil inhibits the breakdown of cGMP, while nitrates increase production of cGMP.
What is the mechanism of action of nitric oxide?
It stimulates the production of cyclic GMP leading to relaxation of the muscle
cells.
Which of the following is an antidote for cyanide poisoning? Sodium nitrite
What is a potential side effect of gemfibrozil?
Myopathy
What is the primary mechanism of action of bile acid sequestrants, such
as resins like cholestyramine and colestipol in lipid control?
They prevent the reabsorption of bile acids in the gut, leading to
increased cholesterol use in bile acid production.
What is an indication for gemfibrozil?
Hypertriglyceridemia
What is NOT a potential adverse effect of fibrates?
Hypertriglyceridemia
Which statement regarding class 4 anti-arrhythmic agents is most
accurate?
It includes calcium channel blockers verapamil and diltiazem.
Amiodarone, sotalol
What is a toxicity associated with amiodarone?
Pulmonary fibrosis
Which medication has potential toxicities including chronic interstitial
pneumonitis, thyroid dysfunction, and sinus bradycardia?
Amiodarone
Corneal verticillata, seen in the image, is most commonly associated
with which medication?
Amiodarone
What is NOT a potential toxicity of amiodarone?
Serositis
Which chiral mixture is a group 3 antiarrhythmic agent?
Sotalol
What is the mechanism of action of class 1A antiarrhythmic agents?
Prolonging the action potential by blocking sodium channels
What is not a class 1A antiarrhythmic agent?
Amiodarone
Which Class I antiarrhythmic drug is known for being particularly
effective in ischemic or depolarized myocardial tissue and is often used
as a first or second-line choice in advanced cardiac life support for
ventricular arrhythmias?
Lidocaine
What best describes the action of lidocaine?
It blocks sodium channels and raises the depolarization threshold.
Which statement regarding lidocaine is most accurate?
It is most effective for the treatment of ventricular arrhythmias.
Which agent is most likely to increase the duration of the QRS
complex?
Flecainide
Which class of antiarrhythmic drugs is least effective in atrial
arrhythmias?
Class 1B
What is the mechanism of action of class 1A antiarrhythmic agents?
Prolonging the action potential by blocking sodium channels
Procainamide belongs to which class of antiarrhythmic medications?
Class 1
Verapamil belongs to which class of antiarrhythmic medications?
Class 4
Esmolol belongs to which class of antiarrhythmic medications?
Class 2
Amiodarone belongs to which class of antiarrhythmic medications?
class 3
Magnesium sulfate belongs to which class of antiarrhythmic medications?
class 5
What best describes the mechanism of class 3 antiarrhythmic drugs?
Potassium channel blockers
What statement about the mechanism of action of PCSK9 inhibitors is most
accurate?
They cause higher hepatic LDL receptor expression and lower plasma LDL-C
levels.
What is a potential adverse effect of PCSK9 inhibitors?
Injection site reactions
What is the primary action of PCSK9 inhibitors (e.g., Praluent or
Repatha) in cholesterol control?
Which medication increases the risk of rhabdomyolysis when taken with a
HMG-CoA reductase inhibitor?
Niacin
Which enzyme is mainly responsible for the breakdown of statins?
CYP
Which statement about ezetimibe is INCORRECT?
There is no increase in the risk for hepatoxicity when combined with
statins.
Which of the following medications is considered an antiplatelet agent?
Clopidogrel
Which of the following medications are preferred for stroke prevention in
patients with atrial fibrillation?
Blockers of factors Xa or IIa
Intravenous heparin would be best used in which of the following
situations?
In a patient with myocardial infarction which was treated by coronary
angioplasty
Which of the following events is considered the first step in atherosclerotic
plaque formation?
Endothelium injury
Warfarin exerts its anticoagulant effect through which of the following
mechanisms?
Inhibition of the production of the clotting factors II, VII, IX, X
Which of the following pairs is matched correctly?
Apixaban/atrial fibrillation
Which of the following describes hypertrophy Increase in cell size Which of the following contributes to the formation of reactive oxygen species in reperfusion injury? Select all that apply Increased recruitment of inflammatory cells-Damaged mitochondria release free radicals- Atrophy is a decrease in cell size
They inhibit COX-2 expression. They inhibit phospholipase A2. A 34-year-old male is rushed to the ER with severe dyspnea. He mentions he is having an asthmatic attack but forgot his inhaler at home. Which medication would NOT be suitable to treat this acute exacerbation? Leukotriene antagonists What best describes omalizumab? Humanized murine monoclonal antibody Which statement is correct? Montelukast is an antagonist of the LTD4 receptor. When discussing the treatment options for COPD, which of the following is usually the most effective first step to discuss with the patient? Smoking cessation
A patient presents with severe COPD. She asks what her surgical options might include
in the future. Which of the following is NOT a surgical treatment offered for this disease?
Pulmonary catheterization
Treatment options for chronic respiratory failure related to COPD can include pharmacologic and non-pharmacologic therapies. Which of the following is NOT a typical long-term treatment option? Daily steroids to reduce lung inflammation Mouth pain is an adverse effect of which humanized monoclonal antibody? Reslizumab (Cinqair) Which humanized monoclonal antibody binds to IgE on sensitized mast cells? Omalizumab Which of the following is the most important risk factor for chronic obstructive pulmonary disease, worldwide? Smoking
According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), what is the defining ratio of FEV1/FVC for confirmation of chronic obstructive pulmonary disease (COPD)? Less than 0. Which is the best combination for the treatment of mild asthma? Inhaled corticosteroids + SABA
Which of the following can contribute to poor control of asthma symptoms?
Use of inhalers only during acute episodes of asthma exacerbation
A patient with a 2-year history of asthma, previously well controlled, presents for progressive worsening of symptoms in spite of good adherence to treatment with scheduled steroid inhalers. The patient has no exposure to pets and is not a smoker. Chest X-ray is unremarkable. What pathology should this patient be worked up for? Allergic bronchopulmonary aspergillosis Which statement concerning angiotensin II is correct? It increases Na+ and Cl- reabsorption. Which of the following conditions causes hypertension because of increased growth hormone levels? Acromegaly Which of the following is a cardiovascular cause of hypertension? Coarctation of the aorta Which of the following is the neurogenic cause of hypertension? Sleep apnea What is the name of the innermost layer of all blood vessels? Tunica intima Which vessel layer is correctly paired with its descriptor? Adventitia - loose connective tissue that contains nerve fibers and the vasa vasorum
Circulating immune complexes What is a common cause of vascular injury? Smoking What is the response of smooth muscle cells to vascular injury? Production of matrix material What recruits smooth muscle cells to the site of vascular injury Chemokines What principally drives the coagulation cascade after an injury? Extrinsic pathway In connective tissue disorders (e.g., Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome), what location of the aorta is weak and susceptible to damage? Media Which type of trauma increases the chance of aortic dissection? Rapid deceleration Which drug can increase the risk of aortic dissection? Cocaine What component of the immune system interacts with antiendothelial cell antibodies and results in the recruitment of neutrophils? Complement In general, what complication is caused by the destruction of the endothelium? Thrombosis Thrombin cleaves which of the following factors? V, VIII, XIII Thrombin is necessary for which of the following events? Endothelial activation Which of the following is an intrinsic factor that affects venous return to the heart? Musculovenous pump
Which of the following is a modifiable factor in the development of varicose veins? Obesity Which statement is correct concerning the risk factors in the development of varicose veins? Pregnancy increases the risk. Which of the following could be a complication of varicose veins Stasis dermatitis Which of the following is an extrinsic factor that affects venous return to the heart? Gravity Which of the following statements is correct concerning the risk factors of deep venous thrombosis? A postoperative state increases the risk. Which of the following anatomic structures is most susceptible to deep vein thrombosis Great saphenous vein Which of the following medications is associated with an increased risk of deep vein thrombosis? Oral contraceptive pills The coronary sinus is a continuation of which of the following veins Great cardiac vein Which of the following risk factors is NOT related to calcific valvular degeneration? Elevated serum calcium levels Which aspect of the aortic valve system is typically affected by calcific degeneration Outflow surface of the aortic valve What is the current treatment for symptomatic calcific aortic valve stenosis Surgical valve replacement What is the term that describes vascular remodeling to maintain constant flow despite increases in atherosclerotic lesion mass? Glagov phenomenon
